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Subarachnoid hemorrhage randomized

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https://www.readbyqxmd.com/read/29683965/effect-of-dexmedetomidine-on-cerebral-vasospasm-and-associated-biomarkers-in-a-rat-subarachnoid-hemorrhage-model
#1
Young Song, Beom Jin Lim, Do-Hyeong Kim, Jin Woo Ju, Dong Woo Han
BACKGROUND: The α2 adrenergic agonist dexmedetomidine (DEX) has huge potential for protecting against cerebral vasospasm, a leading cause of death and disability after subarachnoid hemorrhage (SAH). Biomarker assays for SAH have recently emerged as tools for predicting vasospasm and outcomes. We investigated the effects of DEX on vasospasm and assessed relevant biomarkers in a rat SAH model. METHODS: Male Wistar rats were randomly assigned to sham (n=10), vehicle (n=10), SAH (n=10), or SAH+ DEX (n=10) groups...
April 20, 2018: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/29682020/morphometric-analysis-of-dose-dependent-effect-of-progesterone-on-experimental-vasospasm-induced-rat-femoral-arteries
#2
Metin Kasap, Huseyin Canaz, Gokhan Canaz, Mehmet Tokmak, Alper Bingul, Ibrahim Alatas
Objective: Our aim of this study was to determine effective doses of progesterone which has a vasodilatory effect during the early stage of vasospasm. Cerebral vasospasm (CV) is a predominant cause of morbidity and mortality which develops following subarachnoidal hemorrhage (SAH). Etiopathogenesis of CV is multifactorial. Despite many previously performed studies on this issue, the mechanism by which blood and blood products in the subarachnoidal space induce CV has not been clarified yet...
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29682015/spinal-cerebrospinal-fluid-drainage-for-prevention-of-vasospasm-in-aneurysmal-subarachnoid-hemorrhage-a-prospective-randomized-controlled-study
#3
Sachin Anil Borkar, Manmohanjit Singh, Shashank Sharad Kale, Ashish Suri, Poodipedi Sarat Chandra, Rajender Kumar, Bhawani Shankar Sharma, Shailesh Gaikwad, Ashok Kumar Mahapatra
Introduction: Cerebral vasospasm following aneurysmal subarachnoid hemorrhage (SAH) is a major cause of mortality and morbidity. Despite various treatment modalities, the optimal management of vasospasm remains elusive. In this regard; we undertook a prospective, randomized controlled study to evaluate the effectiveness of lumbar cerebrospinal fluid drainage (LCSFD) for prevention of cerebral vasospasm and its sequelae. Materials and Methods: Patients with aneurysmal SAH who met the inclusion criteria were randomized into two groups - Group I (30 patients) underwent LCSFD whereas Group II (30 patients) did not undergo LCSFD...
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29672747/stress-in-patients-with-un-ruptured-intracranial-aneurysms-vs-population-based-controls
#4
Arno de Wilde, Paut Greebe, Gabriël J E Rinkel, Ale Algra
BACKGROUND: Stress is associated with increased risk of stroke and might predispose to presence and rupture of intracranial aneurysms. OBJECTIVE: To study the association of recent and lifelong stress with unruptured intracranial aneurysm (UIA) and aneurysmal subarachnoid hemorrhage (ASAH). METHODS: In 227 UIA patients (mean age 61 ± 11 yr), 490 ASAH patients (59 ± 11 yr), and 775 controls (51 ± 15 yr) who were randomly retrieved from the general population, we assessed occurrence of major life events and perceived stress during the preceding 12 mo and the entire life...
April 17, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29656002/dangers-of-outpatient-nimodipine-use-after-spontaneous-subarachnoid-hemorrhage-in-accordance-with-the-comprehensive-stroke-center-guidelines
#5
Ching-Jen Chen, Cassie Turnage, Jennifer D Sokolowski, Jeyan S Kumar, M Yashar Kalani, Min S Park
Despite the adverse effects and unclear benefit of the complete 21-day course of nimodipine therapy, The Joint Commission mandates adherence to nimodipine treatment for 21 days after hemorrhage or after hospital discharge if discharged within 21 days for Comprehensive Stroke Center (CSC) certification. We hereby present a 67 year-old male patient with Hunt-Hess grade 2 and Fisher grade 3 non-aneurysmal spontaneous subarachnoid hemorrhage who was discharged with oral nimodipine as stipulated by the CSC guidelines, and subsequently developed symptomatic hypotension...
April 11, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29649643/estimating-the-global-incidence-of-aneurysmal-subarachnoid-hemorrhage-a-systematic-review-for-central-nervous-system-vascular-lesions-and-meta-analysis-of-ruptured-aneurysms
#6
REVIEW
Joshua D Hughes, Kamila M Bond, Rania A Mekary, Michael C Dewan, Abbas Rattani, Ronnie Baticulon, Yoko Kato, Hildo Azevedo-Filho, Jacques J Morcos, Kee B Park
INTRODUCTION: There is increasing acknowledgement that surgical care is important in global health initiatives. In particular, neurosurgical care is as limited as 1-to-10 million people in parts of the world. We performed a systematic literature review to examine the worldwide incidence of central nervous system vascular lesions (CNS-VL) and a meta-analysis of aneurysmal subarachnoid hemorrhage (ASAH) in order to define the disease burden and inform neurosurgical global health efforts...
April 9, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29626133/long-term-risk-of-hemorrhagic-stroke-in-young-patients-with-congenital-heart-disease
#7
Kok Wai Giang, Zacharias Mandalenakis, Mikael Dellborg, Georgios Lappas, Peter Eriksson, Per-Olof Hansson, Annika Rosengren
BACKGROUND AND PURPOSE: The risk of ischemic stroke is increased in patients with congenital heart disease (CHD); however, data on the risk of hemorrhagic stroke, including intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH), are lacking. METHODS: The Swedish Patient Register was used to identify all patients who were born with a diagnosis of CHD between 1970 and 1993. Each patient was compared with 10 randomly selected controls from the general population, matched for age, sex, and county...
April 6, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29619929/depression-stroke-and-dementia-in-patients-with-myocardial-infarction
#8
Jens Sundbøll
The connection between the heart and mind has been studied since Sir William Harvey observed more than 350 years ago that negative emotions adversely affect the heart. Today, we know that diseases of the mind can affect the heart and, conversely, that heart diseases can cause both physical and mental diseases of the brain. To explore this relation further, we examined how previous depression affects survival in patients with myocardial infarction (MI) (study II), and how the occurrence of MI affects the risk of ischemic and hemorrhagic stroke (study III) and dementia (study IV)...
April 2018: Danish Medical Journal
https://www.readbyqxmd.com/read/29609651/the-use-of-standardized-management-protocols-for-critically-ill-patients-with-non-traumatic-subarachnoid-hemorrhage-a-protocol-of-a-systematic-review-and-meta-analysis
#9
Shaurya Taran, Vatsal Trivedi, Jeffrey M Singh, Shane W English, Victoria A McCredie
BACKGROUND: Caring for patients with subarachnoid hemorrhage (SAH) presents unique challenges, due in part to the severity of the underlying insult, competing systemic injuries, and unpredictable clinical course. Even when management occurs in dedicated critical care settings, treatment uncertainty often persists, and morbidity and mortality from the condition remain high. Complex decisions in SAH care may be simplified with the use of standardized management protocols (SMPs). SMPs incorporate evidence-based guidelines into a practical framework for decision-making, thereby providing clinicians with an algorithm for organizing treatments...
April 2, 2018: Systematic Reviews
https://www.readbyqxmd.com/read/29592873/atorvastatin-ameliorates-early-brain-injury-through-inhibition-of-apoptosis-and-er-stress-in-a-rat-model-of-subarachnoid-hemorrhage
#10
Wentao Qi, Demao Cao, Yucheng Li, Aijun Peng, Youwei Wang, Kai Gao, Cunshan Tao, Yongkang Wu
Objective: Aneurysmal subarachnoid hemorrhage (SAH) is a severe cerebrovascular disease with very poor prognosis. The aim of this study was to evaluate the protective effects of atorvastatin on early brain injury (EBI) after SAH using a perforation SAH model. Methods: Male Sprague-Dawley rats were randomly divided into four groups: the sham group, the SAH group (model group), SAH + 10 mg·kg-1 ·d-1 atorvastatin (low atorvastatin group), and SAH + 20 mg·kg-1 ·d-1 atorvastatin (high atorvastatin group). Atorvastatin was administered orally by gastric gavage for 15 days before operation...
March 28, 2018: Bioscience Reports
https://www.readbyqxmd.com/read/29589328/influence-of-bleeding-pattern-on-ischemic-lesions-after-spontaneous-hypertensive-intracerebral-hemorrhage-with-intraventricular-hemorrhage
#11
Lucia Rivera-Lara, Santosh B Murthy, Saman Nekoovaght-Tak, Hasan Ali, Nichol McBee, Rachel Dlugash, Malathi Ram, Richard Thompson, Issam A Awad, Daniel F Hanley, Wendy C Ziai
BACKGROUND: Concomitant acute ischemic lesions are detected in up to a quarter of patients with spontaneous intracerebral hemorrhage (ICH). Influence of bleeding pattern and intraventricular hemorrhage (IVH) on risk of ischemic lesions has not been investigated. METHODS: Retrospective study of all 500 patients enrolled in the CLEAR III randomized controlled trial of thrombolytic removal of obstructive IVH using external ventricular drainage. The primary outcome measure was radiologically confirmed ischemic lesions, as reported by the Safety Event Committee and confirmed by two neurologists...
March 27, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29563984/aloperine-activates-the-nrf2-are-pathway-when-ameliorating-early-brain-injury-in-a-subarachnoid-hemorrhage-model
#12
Shibin Song, Yimin Chen, Feng Han, Minghao Dong, Xin Xiang, Jianmei Sui, Yuming Li, Hua Yang, Jian Liu
Aloperine (ALO) exhibits neuroprotective effects against oxidative stress in vitro ; however, its protective effect in early brain injury (EBI) following experimental subarachnoid hemorrhage (SAH) remains to be elucidated. The aim of the current study was to evaluate the antioxidant activity of ALO in EBI, and its association with nuclear factor erythroid-related factor 2 and the antioxidant responsive element (Nrf2-ARE) survival pathway. In the present study, an experimental SAH model was induced in rats following a prechiasmatic cistern injection...
April 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29556884/predicting-delayed-cerebral-ischemia-after-subarachnoid-hemorrhage-using-physiological-time-series-data
#13
Soojin Park, Murad Megjhani, Hans-Peter Frey, Edouard Grave, Chris Wiggins, Kalijah L Terilli, David J Roh, Angela Velazquez, Sachin Agarwal, E Sander Connolly, J Michael Schmidt, Jan Claassen, Noemie Elhadad
To develop and validate a prediction model for delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH) using a temporal unsupervised feature engineering approach, demonstrating improved precision over standard features. 488 consecutive SAH admissions from 2006 to 2014 to a tertiary care hospital were included. Models were trained on 80%, while 20% were set aside for validation testing. Baseline information and standard grading scales were evaluated: age, sex, Hunt Hess grade, modified Fisher Scale (mFS), and Glasgow Coma Scale (GCS)...
March 20, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29546590/deficiency-of-tenascin-c-alleviates-neuronal-apoptosis-and-neuroinflammation-after-experimental-subarachnoid-hemorrhage-in-mice
#14
Lei Liu, Masashi Fujimoto, Fumi Nakano, Hirofumi Nishikawa, Takeshi Okada, Fumihiro Kawakita, Kyoko Imanaka-Yoshida, Toshimichi Yoshida, Hidenori Suzuki
Tenascin-C (TNC), a matricellular protein, is upregulated in brain parenchyma after experimental subarachnoid hemorrhage (SAH). Recent studies emphasize that early brain injury (EBI) should be overcome to improve post-SAH outcomes. The aim of this study was to investigate effects of TNC knockout (TNKO) on neuronal apoptosis and neuroinflammation, both of which are important constituents of EBI after SAH. C57BL/6 wild-type (WT) mice or TNKO mice underwent sham or filament perforation SAH modeling. Twenty-five WT mice and 25 TNKO mice were randomly divided into sham+WT (n = 10), sham+TNKO (n = 8), SAH+WT (n = 15), and SAH+TNKO (n = 17) groups...
March 15, 2018: Molecular Neurobiology
https://www.readbyqxmd.com/read/29540123/magnesium-sulfate-in-combination-with-nimodipine-for-the-treatment-of-subarachnoid-hemorrhage-a-randomized-controlled-clinical-study
#15
Chenhao Zhang, Shuqin Zhao, Yanjing Zang, Weidong Zhao, Qin Song, Shanshan Feng, Lei Hu, Fang Gu
Objective Cerebral vasospasm(CVS) after Subarachnoid hemorrhage (SAH) can cause delayed cerebral ischemia,secondary cerebral infarction, and rehemorrhage, which are the leading causes of mutilation and death. Nimodipine has been shown to prevent CVS. Magnesium ion (Mg2+ ) can competitively inhibit the influx of calcium (Ca2+ ) and prevent vasospasm. There is evidence that magnesium sulfate can prevent CVS and reduce infarct volume after SAH. In this study, we evaluated the efficacy and safety of intravenous magnesium sulfate combined with oral nimodipine on CVS, delayed cerebral ischemia, secondary cerebral infarction, and rehemorrhage after SAH...
April 2018: Neurological Research
https://www.readbyqxmd.com/read/29511128/risk-factors-for-and-clinical-consequences-of-multiple-intracranial-aneurysms-a-systematic-review-and-meta-analysis
#16
Ramazan Jabbarli, Thiemo Florin Dinger, Marvin Darkwah Oppong, Daniela Pierscianek, Philipp Dammann, Karsten H Wrede, Klaus Kaier, Martin Köhrmann, Michael Forsting, Christoph Kleinschnitz, Ulrich Sure
BACKGROUND AND PURPOSE: Multiple intracranial aneurysms (MIAs) are common findings of cerebral angiographies; however, MIA prevalence varies in different patient cohorts. We sought to elucidate risk factors influencing MIA prevalence and the clinical consequences. METHODS: We systematically searched PubMed, Scopus, Embase, and Cochrane Library databases for publications before January 15, 2017, reporting MIA prevalence and risk factors. We used random-effects meta-analysis and multivariate regression analysis to assess the impacts of individual, study, and population characteristics...
March 6, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29460112/association-between-oral-contraceptives-and-risk-of-hemorrhagic-stroke-a-meta-analysis-of-observational-studies
#17
Zhenlin Xu, Yuanping Yue, Jianling Bai, Chong Shen, Jingjing Yang, Xiaoping Huang, Yang Zhao, Ying Li
OBJECTIVES: To estimate the risk of hemorrhagic stroke associated with current use of oral contraceptives (OCs), and to further depict how the risk was affected by study characteristics. METHODS: We searched PubMed, Embase, and Cochrane Library for relevant articles published up to February 2017 that examined the association between OC use and risk of hemorrhagic stroke. Two investigators independently reviewed articles based on inclusion criteria. The Newcastle-Ottawa scale was employed to evaluate quality of studies...
February 19, 2018: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29456646/an-experimental-rabbit-model-of-symptomatic-cerebral-vasospasm-with-in-vivo-neuroimaging-assessment-and-ex-vivo-histological-validation
#18
Yunchang Mo, Luping Huang, Linbi Chen, Michael Veronesi, Yiyi Shi, Sijia Chen, Linli Peng, Leping Zhou, Yonglin Pu, Junlu Wang
Cerebral vasospasm (CVS) is a severe complication that occurs following aneurysmal subarachnoid hemorrhage (SAH). Magnetic resonance angiography (MRA) has been used to evaluate brain injury following SAH in humans. The present study was designed to assess a rabbit model of symptomatic CVS (SCVS) and the utility of MRA in evaluating SCVS in rabbits. Japanese white rabbits (n=24) were randomly divided into 2 equal groups: A sham group and a SAH group. Neurological scores were evaluated for 7 days following SAH...
March 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29425980/dose-dependent-effects-of-statins-for-patients-with-aneurysmal-subarachnoid-hemorrhage-meta-regression-analysis
#19
REVIEW
Minh-Son To, Shivesh Prakash, Santosh I Poonnoose, Shailesh Bihari
OBJECTIVE: The study utilizes meta-regression analysis to quantify the dose-dependent effects of statin pharmacotherapy on vasospasm, delayed ischemic neurologic deficits (DINDs) and mortality in aneurysmal subarachnoid hemorrhage (aSAH). METHODS: Prospective, retrospective observational studies and randomized controlled trials (RCTs) were retrieved by a systematic database search. Summary estimates were expressed as absolute risk (AR) for a given statin dose or control (placebo)...
February 6, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29406421/outcomes-and-costs-of-patients-admitted-to-the-icu-due-to-spontaneous-intracranial-hemorrhage
#20
Shannon M Fernando, Peter M Reardon, Dar Dowlatshahi, Shane W English, Kednapa Thavorn, Peter Tanuseputro, Jeffrey J Perry, Erin Rosenberg, Eelco F Wijdicks, Daren K Heyland, Kwadwo Kyeremanteng
OBJECTIVES: Spontaneous intracranial hemorrhage, including subarachnoid hemorrhage and intracerebral hemorrhage, is associated with significant morbidity and mortality. Although many of these patients will require ICU admission, little is known regarding their outcomes and the costs incurred. We evaluated this population in order to identify outcomes and cost patterns. DESIGN: Retrospective cohort analysis of a health administrative database. SETTING: Two ICUs within a single hospital system...
February 5, 2018: Critical Care Medicine
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